Tuesday, 24 September 2013

Bipolar

I see that I haven’t updated my blog since mid-May. This is
because I’ve been off having adventures in the dark recesses of my brain.

Where I’d left the long story of my mental health, is
that I’d seen a psychiatrist, and he’d prescribed me a new antidepressant,
Mirtazapine. For a good few weeks, Mirtazapine was a wonder drug. It saved my
life. I stopped actively looking for ways to die and started settling down.

Unfortunately, that only lasted about 8 weeks, before the recovery started tailing off. I was completely unable to feel joy, but
was more or less content with this. Who needs joy anyway?

The psychiatrist thought that ‘happy’ really ought to be on
the agenda, so he increased my dose. It was not the miracle cure it had been
before.

A couple of weeks after that, I started moving backwards
again. Making plans, new plans, because I’d told people my old ones and I
needed to work in secret. I started quietly saying goodbye and not committing
to anything beyond the next few weeks. I started trying to work out how the
practicalities would work after I was gone.

I stopped being able to love my children. I’d like to say
that this frightened or upset me, but I didn’t have any reaction to it at all.
I felt like an empty glass. Occasionally, some emotions would break through,
but they’d usually be the tricky ones; rage and fear and hatred. I knew, on an abstract
level, that all of this was a bit not good, but it had just become part and
parcel of who I was.

I went back to the psychiatrist to explain this to him, and
we decided to try a new combination of antidepressants, so he added Venlofaxine
to the Mirtazapine.

I’m not sure I can adequately express the hell that was
Venlofaxine.

The physical side effects were difficult. My nerves became
super-sensitive and I’d have hours and hours of tingling and buzzing skin which
drove me up the wall. Water started feeling hard and rough. My digestive system ground to a complete standstill, regardless of overdosing on several things to free it up again. My
pupils were permanently dilated making me really light sensitive. I felt
drugged and exhausted constantly.

All of this might have been worth working through if it
weren’t for the effect that it had on my brain.

My GP has recently shared with me the fact that I’d said a
couple of things back in March which crossed the fuzzy, grey line from neurosis
to psychosis. She wasn’t sure, but this was why she wanted me to see a
psychiatrist. I have no idea what these things might have been – at the time, I
thought I was being perfectly logical. Up until August, I was quite prepared to
say that I’d never experienced a psychotic thought.

In August, while on the Venlofaxine, the thoughts that were
coming at me were so out and out mental
that I’m pretty darn certain that at least some of them were psychotic.

One of the peculiarities of that time was the incongruity
between what I was feeling and how I was thinking and acting. I described it to
a friend as if I were at a great party, all dressed up and bouncing around the
dance floor, grin on my face, pulling everyone in to dance, while tears were
coursing down my face and shouting ‘I hate myself! I am totally evil! Hahahaha!
Guess what, guys? I want to die! Isn’t that a hoot!’

I would spend hours silently curled up, trying desperately
not to accidentally let this lunatic out.

I had to pay attention to every single thought and word in
case it was not a normal one.

One evening I was hot and feeling claustrophobic, so I
thought ‘I know, I’ll pop out for a walk up the road in the rain! That’ll work!
There’s no point getting dressed for it or putting my shoes on. If anyone asks
me, I’ll just pretend I can’t see them.’

And the sane side of me wearily going; ‘No, Pip, you can’t
do that.’ That sane side put up one hell of a fight, and I stayed in.

I stopped being able to tell what was real and what was not.
I was pretty convinced that everything that came out of my mouth was a lie. I
had the strange sensation that I had actually already died, and that this reality
was just hanging onto me for some reason. I was convinced that everyone else
either couldn’t see me, or was disgusted by me hanging around. I deleted a
number of my friends from Facebook, convinced that they hated me. As yet, I
haven’t been courageous enough to ask for them back. How do you word that? ‘Hi,
a couple of months ago I assumed I didn’t exist, and that you hated me because
I was an angry ghost. Any chance you’ll be my friend again?’

I called the psychiatrist and asked if I could stop taking
the Venlofaxine. I begged him while talking at 500 words a minute, and he
eventually cut in and said it was a good idea.

A couple of days later, I made a tiny, but stupid mistake
with something.

I went mad. Literally mad.

Those thoughts started flying at me. I was, of course,
stupid and evil, or I wouldn’t have made such a mistake. I should go away. Just
get in the car and keep driving until there was nothing, and then walk into the
sea.

No, Pip, you must not do that.

Fine, then I’ll just stay in the graveyard behind the house.
That’s where I’ll live now. I can at least stay here until my husband gets
home, and then he can fix it and perhaps send the tent out to me.

And then there was a pair of scissors in my hand and I was
using them to whip my arm. It wasn’t deep or dangerous (I’m very clever at
hurting myself so it won’t show for too long), but it cut and it bled and eventually
it the pain worked its way into my brain.

And then I was looking down at my bloody arm, and was I furious
that I’d lost concentration and let the crazy out. I still
can’t say precisely what happened. Only that I was tired beyond everything, and
I lost concentration for just a minute but that minute was all that was needed.

When I went back to the psychiatrist the week after that, I
started telling him about the visions and voices for the first time. The voices
are a part of me. I mean that literally; I’m aware that the TV and the radio
aren’t talking to me. I can’t stop them – the constant, draining ‘you’re
rubbish, you’re pathetic, you should just go ahead and die…’ these are a
constant soundtrack to my life, but I know that they’re me. Sometimes I can
overrule them. I’ve had some, limited success with mindfulness and meditation.
Other times not so much, and if I try to clear my head, it just fills instantly
with louder, more vicious voices, grinding me down and down, making me more
exhausted, and then I can’t fight them at all.

There have been a couple of occasions when the voices have
sounded external, but on those occasions, they were soothing. I heard God
talking from the corner cupboard once, telling me things were going to be OK.
On another occasion, I was in a top bunk and became aware that my dead grandfather
was on the bottom one, telling me it would all be fine. Obviously I lay as
still as a rock on the top bunk, terrified to move just in case he was really
there.

More often, the audio hallucinations are bangs, screams and
crashes. The worst ones sound like a bookshelf has snapped and everything has
fallen from it. Though I could live without the screams too. Generally speaking
with these, I can wander round, establish that nobody is screaming and that
nothing has fallen, and I put it down to being very tired and stressed. And I
don’t report them to anyone.

The visions are also quite rare. They’re usually nasty
images; me lying in a bath full of blood, opened up and drained. Me lying dead
on the kitchen floor. Blood pulsing from my wrists to the floor. That sort of
thing. Again, I’m usually quite able to tell that these things originate from
inside me. I know they aren’t a prediction of the future or a set of
instructions. I’m able to force myself to look and prove that they’re not
really there (apart from one occasion when I was just too tired, so thought
‘fuck it, if that’s what my brain wants to see, that’s what I’m going to see…’)

The more usual visions are little aftershock things – just
something I glimpse that make me jump and my heart race and my mouth dry.
Little, everyday things that make me uncertain of what’s really there and leave
me off-balance. I’m pretty sure everyone gets these from time to time, so I
didn’t report them. It didn’t occur to me that I was getting rather a lot of
them.

It simply didn’t occur to me that these were symptomatic of
something other than chronic and severe depression, and that I needed to
perhaps share them. When I finally did so, the psychiatrist calmly pointed out
that just because I know they’re all coming from my brain, that doesn’t
necessarily mean that they should be there.

There are other things too that point towards a bipolar diagnosis. I can’t
take SSRIs and I now know people with bipolar regularly react to SSRIs. The writing that I do –
some of that was great and lovely, but other parts of it were wildly out of
control. I should not have been able to write two novels
in 18 months while working full time and raising two children, while also
writing hundreds and thousands of words of fanfic. That’s a few steps beyond
‘driven’.

All of this time, I was also sedated. I should have been
calm and quiet. I still managed to not sleep for weeks on end, just waiting until I literally passed out.

So, we're tentatively stepping towards bipolar, and the end result is that I'm now on an anti-psychotic and mood
stabilizer.

It is amazing. I did not realise how noisy my head was
until that noise was suddenly stopped. I can now step outside and do some
mindfulness, and I relax, as I’m meant to. I’m no longer fighting through this
wall of nonsense to get anything done, or trying to physically keep a pace with the speed that my thoughts are hitting me, so I’m no longer as crushingly tired.

There’s still a way to go. This is the longest amount of
writing I’ve done for a couple of months. I’m also aware that it’s turned wordy
and epic. I can’t tell whether that’s a sign of the mania, or a sign that some
of the creative side of me is coming back. These things are no longer straight
forward to identify.

I love my children. I utterly love my children, and the
relief there is overwhelming too.

I’ve had false dawns before with this thing (and I’m very
aware of the rate of bipolar relapses), so I’m slightly wary of dancing about
and declaring that I’m better. But right now, I’m happy to breathe deeply and
feel that fresh air, and to listen to the nice, quiet sounds of the world.